Table 2.
GRADE evidence profile of thirty-three eligible studies
| Outcomes | GRADE evidence profile* |
Number of participants (studies) | Effect size (Cohen’s d) | Quality of the evidence (GRADE) | ||||
|---|---|---|---|---|---|---|---|---|
| Risk of bias | Inconsistency | Indirectness | Imprecision | Control group | Intervention group | |||
| Individual coaching intervention compared to no intervention | ||||||||
|
Population: Resident physicians Setting: Training center Intervention: Individual coaching intervention Comparison: No intervention | ||||||||
|
Emotional exhaustion assessed with • 22-item MBI, with score ranging from 0 (low EE) to 54 (high EE) (n = 13) • 16-item MBI, with score ranging from 0 (low EE) to 30 (high EE) (n = 1) • 9-item aMBI, with score ranging from 0 (low EE) to 18 (high EE) (n = 2) |
Serious | Serious | Not serious | Not serious | 587 (5 historical-control, 6 self-control, 5 RCT studies) | 528 (5 historical-control, 6 self-control, 5 RCT studies) | 0.24 lower (0.40 lower to 0.07 lower) |
Very low ⊕⊖⊖⊖ |
|
Depersonalization assessed with • 22-item MBI, with score ranging from 0 (low DP) to 30 (high DP) (n = 13) • 16-item MBI, with score ranging from 0 (low DP) to 30 (high DP) (n = 1) • 9-item aMBI, with score ranging from 0 (low DP) to 18 (high DP) (n = 2) |
Serious | Serious | Not serious | Not serious | 587 (5 historical-control, 6 self-control, 5 RCT studies) | 528 (5 historical-control, 6 self-control, 5 RCT studies) | 0.20 lower (0.41 lower to 0.01 higher) |
Very low ⊕⊖⊖⊖ |
| Individual coaching intervention compared to no intervention, continued | ||||||||
|
Personal accomplishment assessed with • 22-item MBI, with score ranging from 0 (low PA) to 48 (high PA) (n = 11) • 16-item MBI, with score ranging from 0 (low PA) to 36 (high PA) (n = 1) • 9-item aMBI, with score ranging from 0 (low PA) to 18 (high PA) (n = 2) |
Serious | Serious | Not serious | Not serious | 451 (4 historical-control, 5 self-control, 5 RCT studies) | 394 (4 historical-control, 5 self-control, 5 RCT studies) | 0.16 higher (0.10 lower to 0.42 higher) |
Very low ⊕⊖⊖⊖ |
| Individual meditation intervention compared to no intervention | ||||||||
|
Population: Resident physicians Setting: Training center Intervention: Individual meditation intervention Comparison: No intervention | ||||||||
|
Emotional exhaustion assessed with • 22-item MBI, with score ranging from 0 (low EE) to 54 (high EE) (n = 5) • 20-item MBI with score ranging from 0 (low EE) to 48 (high EE) (n = 1) • 9-item aMBI, with score ranging from 0 (low EE) to 18 (high EE) (n = 3) |
Serious | Not serious | Not serious | Not serious | 250 (1 historical-control, 4 self-control, 4 RCT studies) | 241 (1 historical-control, 4 self-control, 4 RCT studies) | 0.33 lower (0.59 lower to 0.08 lower) |
Very low ⊕⊖⊖⊖ |
| Individual meditation intervention compared to no intervention, continued | ||||||||
|
Depersonalization assessed with • 22-item MBI, with score ranging from 0 (low DP) to 30 (high DP) (n = 5) • 20-item MBI with score ranging from 0 (low DP) to 30 (high DP) (n = 1) • 9-item aMBI, with score ranging from 0 (low DP) to 18 (high DP) (n = 3) |
Serious | Not serious | Not serious | Not serious | 249 (1 historical-control, 4 self-control, 4 RCT studies) | 241 (1 historical-control, 4 self-control, 4 RCT studies) | 0.11 lower (0.34 lower to 0.11 higher) |
Very low ⊕⊖⊖⊖ |
|
Personal accomplishment assessed with • 22-item MBI, with score ranging from 0 (low PA) to 48 (high PA) (n = 4) • 20-item MBI, with score ranging from 0 (low PA) to 42 (high PA) (n = 1) • 9-item aMBI, with score ranging from 0 (low PA) to 18 (high PA) (n = 3) |
Serious | Not serious | Not serious | Not serious | 233 (1 historical-control, 4 self-control, 3 RCT studies) | 215 (1 historical-control, 4 self-control, 3 RCT studies) | 0.21 higher (0.03 higher to 0.40 higher) |
Very low ⊕⊖⊖⊖ |
| Organizational work-hour intervention compared to no intervention | ||||||||
|
Population: Resident physicians Setting: Training center Intervention: Organizational work-hour intervention Comparison: No intervention | ||||||||
|
Emotional exhaustion assessed with • 22-item MBI, with score ranging from 0 (low EE) to 54 (high EE) (n = 6) |
Serious | Serious | Not serious | Serious | 308 (2 historical-control, 2 self-control, 2 RCT studies) | 313 (2 historical-control, 2 self-control, 2 RCT studies) | 0.20 lower (0.58 lower to 0.17 higher) |
Very low ⊕⊖⊖⊖ |
| Organizational work-hour modification intervention compared to no intervention, continued | ||||||||
|
Depersonalization assessed with • 22-item MBI, with score ranging from 0 (low DP) to 30 (high DP) (n = 6) |
Serious | Serious | Not serious | Serious | 308 (2 historical-control, 2 self-control, 2 RCT studies) | 313 (2 historical-control, 2 self-control, 2 RCT studies) | 0.16 lower (0.49 lower to 0.16 higher) |
Very low ⊕⊖⊖⊖ |
|
Personal accomplishment assessed with • 22-item MBI, with score ranging from 0 (low PA) to 48 (high PA) (n = 6) |
Serious | Not serious | Not serious | Not serious | 308 (2 historical-control, 2 self-control, 2 RCT studies) | 313 (2 historical-control, 2 self-control, 2 RCT studies) | 0.04 lower (0.12 lower to 0.20 higher) |
Very low ⊕⊖⊖⊖ |
| Organizational improved learning environment compared to no intervention | ||||||||
|
Population: Resident physicians Setting: Training center Intervention: Organizational improved learning environment intervention Comparison: No intervention | ||||||||
|
Emotional exhaustion assessed with • 22-item MBI, with score ranging from 0 (low EE) to 54 (high EE) (n = 2) |
Serious | Serious | Not serious | Serious | 161 (2 historical-control studies) | 148 (2 historical-control studies) | 0.20 lower (0.61 lower to 0.21 higher) |
Very low ⊕⊖⊖⊖ |
|
Depersonalization assessed with • 22-item MBI, with score ranging from 0 (low DP) to 30 (high DP) (n = 2) |
Serious | Serious | Not serious | Serious | 161 (2 historical-control studies) | 148 (2 historical-control studies) | 0.07 lower (0.58 lower to 0.44 higher) |
Very low ⊕⊖⊖⊖ |
|
Personal accomplishment assessed with • 22-item MBI, with score ranging from 0 (low PA) to 48 (high PA) (n = 2) |
Serious | Not serious | Not serious | Not serious | 161 (2 historical-control studies) | 148 (2 historical-control studies) | 0.28 higher (0.05 higher to 0.50 higher) |
Very low ⊕⊖⊖⊖ |
*No studies fulfil the upward rating of evidence in large magnitude of an effect, dose-response gradient, and the effect of plausible residual confounding; no publication bias was found in all outcomes